Coping with
side effects

You may experience a range of side effects during and after cancer treatment. These can affect people differently. Some may require that you take time off work. Others may only be mild and not interfere too much with your job. The most common side effects are:

Tiredness (fatigue) – you may feel very tired and weak and might struggle to do small daily tasks. You may have no energy and feel breathless or dizzy after light activity.

Risk of infection – chemotherapy can cause a drop in your white blood cell count. This may put you at risk of infection.

Risk of bleeding – if your platelet cells are low, you will need to avoid doing things that may cause you to cut yourself or bruise.

Numbness or tingling of the hands or feet (peripheral neuropathy) – some chemotherapy drugs can cause this. It will get better when treatment finishes.

Changes in appearance – treatment can affect the way you look. You may have skin changes, weight changes, hair loss or scars.

Your doctors can give you medicines to help control symptoms. You can also talk to your employer and discuss adjustments that would support you at work. This could include, for example, changing your working hours or duties.

Tiredness

Tiredness (fatigue) is a common problem. You may feel extremely tired as if you have no strength or energy. It may make it hard or sometimes impossible to do everyday things at work. Tiredness can also make it hard to concentrate or make decisions. You may also feel more emotional and less patient than usual.

If you want to carry on working, ask your manager about looking at ways of making your work less tiring. This is part of making reasonable adjustments.

Possible changes could include:

regular rests and short naps – you may find this useful after an activity or a meal

working from home

avoiding physically demanding duties

planning work around times when you have more energy.

Ask your manager if there is a first aid room or comfortable place you can rest. Keeping a note of how you feel can show when you are usually more tired. This can help you to judge when to work and when to rest.

Regular physical activity can help to reduce tiredness. Even taking a short walk on your lunch break could give you more energy. It can also help to reduce stress.

Explaining the effects of fatigue to your colleagues can help them to understand what you’re coping with. It may be difficult for some people to know how tired you are, especially if you look well.

Risk of infection

Some cancer treatments, particularly chemotherapy, can reduce the number of white blood cells. These are the cells that fight infection. This means you are more likely to get an infection. Your doctor or nurse will explain when your white blood cell count is likely to be low.

If your white blood cell count is very low, you may not be able to work.

You will need to avoid people with sore throats, colds, flu, diarrhoea or vomiting, and other kinds of infection such as chickenpox. If you have been in touch with someone with an infection, ask your doctor or nurse for advice as soon as possible.

If you work in busy places, you may be mixing with people who have an infection without being aware of it. If your work allows it, work from home when you are more at risk of infection. Your nurse can tell you when this might be. It is also best to avoid crowds when travelling by public transport. If you can, change your working hours so you can travel at quieter times.

The Access to Work scheme may be able to provide funding for you to get taxis to work if this is an issue.

Risk of bleeding

Numbness or tingling of the hands and feet

Some chemotherapy and targeted therapy drugs affect the nerves. This can cause numbness, pins and needles, or pain in your hands and feet (called peripheral neuropathy). It may make it difficult to hold things or to write or type so certain tasks may take you longer.

Peripheral neuropathy usually gradually gets better in the months after treatment but sometimes it is permanent. We have more information about peripheral neuropathy.

Changes to your appearance

Treatment may cause skin changes, weight changes, hair loss or scars from surgery. This can be hard if your work involves face-to-face meetings with clients or the public.

It takes time to adjust to a change in your appearance and to feel less anxious. We have more information about body image, which can help with dealing with other people’s reactions and managing anxiety.

If you have an obvious change in your appearance, you could ask someone at work to tell the people you work with. Or you may prefer to tell people yourself about the cause of the change.

If your job involves dealing directly with the public, it may help to work with someone else for a while, if this is possible. This is just until you build up your confidence.

Some people may work from home until they feel more confident. If concerns about your body image interfere with work or socialising, it is important to talk to your doctor or nurse. There are different ways they can help you.

Other side effects or symptoms

There may be other side effects or symptoms depending on the type of cancer you have and your treatment. Let your doctor know if you have other difficulties, for example pain, feeling sick or eating problems. They can prescribe medicines to help or give you advice. If your symptoms do not improve, tell your doctor or nurse.

Some people who have finished treatment may develop long-term side effects.

Thanks

We rely on a number of sources to gather evidence for our information. If you’d like further information on the sources we use, please feel free to contact us on: bookletfeedback@macmillan.org.uk

All our information is reviewed by cancer or other relevant professionals to ensure that it’s accurate and reflects the best evidence available. We thank all those people who have provided expert review for the information on this page.

Our information is also reviewed by people affected by cancer to ensure it is as relevant and accessible as possible. Thank you to all those people who reviewed what you're reading and have helped our information to develop.

You could help us too when you join our Cancer Voices Network – find out more at: http://www.macmillan.org.uk/cancervoices

We make every effort to ensure that the information we provide is accurate and up-to-date but it should not be relied upon as a substitute for specialist professional advice tailored to your situation. So far as is permitted by law, Macmillan does not accept liability in relation to the use of any information contained in this publication or third party information or websites included or referred to in it.